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GPH = Gallons per hour, Y = Yes, N = No, NA = Not applicable, VPH = Vacuum/Pressure/Hydrostatic, ID = Identification <br />UNDERGROUND STORAGE TANK <br />MONITORING SYSTEM CERTIFICATION FORM (Page 5 of 6) <br />XII. LINE LEAK DETECTOR TESTING <br /> Check this box if line leak detectors (LLD) are NOT installed. (Do not complete this section.) Y N NA This section must be completed if LLDs are installed. <br />Was a leak simulated to verify LLD performance? (Check all that apply.) Simulated leak rate verified: 3 GPH 0.1 GPH 0.2 GPH <br />Was the testing apparatus properly calibrated? <br />For emergency generator tank systems, does the LLD create an audible and visual alarm when a leak is detected? <br />For mechanical LLDs, does the LLD restrict the flow through the pipe when a leak is detected? <br />For electronic LLDs, does the turbine automatically shut off when a leak is detected? <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system is disabled or disconnected? <br />For electronic LLDs, does the turbine automatically shut off if any portion of the monitoring system malfunctions or fails a test? <br />For electronic LLDs, have all accessible wiring connections been visually inspected for kinks and breaks? <br />Were all items on the equipment manufacturer’s maintenance checklist completed? <br />Were all LLDs confirmed operational within regulatory requirements? <br />For any answer of “N” above, describe in section XIII how and when these issues were or will be corrected. <br />XIII. COMMENTS <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />XIV. VACUUM / PRESSURE/ HYDROSTATIC MONITORING EQUIPMENT TESTING <br /> Check this box if VPH monitoring is NOT used. (Do not complete this section.) <br />This section must be completed if VPH monitoring is used to perform leak detection monitoring. <br />System Type (Mark all that apply.) Vacuum Pressure Hydrostatic <br />Sensor ID Component(s) Monitored by this Sensor Sensor Functionality <br />Test <br />Interstitial <br />Communication Test <br /> Pass Fail Pass Fail <br /> Pass Fail Pass Fail <br /> Pass Fail Pass Fail <br /> Pass Fail Pass Fail <br /> Pass Fail Pass Fail <br /> Pass Fail Pass Fail <br /> Pass Fail Pass Fail <br /> Pass Fail Pass Fail <br /> Pass Fail Pass Fail <br /> Pass Fail Pass Fail <br /> Pass Fail Pass Fail <br /> Pass Fail Pass Fail <br />How was interstitial communication verified? Simulated leak at far ends of the interstitial space. Visual Inspection <br /> Other (Describe the method in section XV below.) Gauge <br />Was the vacuum or pressure restored to operating levels in all interstitial spaces? Yes No (Describe the reason in section XV below.) <br />For any answer of “FAIL” above, describe in section XV how and when these issues were or will be corrected. <br />XV. COMMENTS <br /> <br /> <br /> <br /> <br /> <br /> <br />